Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- headache
- nausea and vomiting
- photophobia
- neck stiffness
- fever
Otros factores de diagnóstico
- rash
- Kernig sign
- Brudzinski sign
Factores de riesgo
- infants and young children
- young adults
- older people
- summer and fall
- exposure to mosquito or tick vector
- unvaccinated for mumps
- use of swimming pools and ponds
- immunosuppression
- exposure to rodents
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- CSF microscopy
- CSF Gram stain
- CSF bacterial culture
- CSF protein
- CSF glucose
- CSF PCR for enteroviruses
- CSF PCR for herpes viruses
- HIV serology/HIV reverse transcriptase (RT)-PCR
Pruebas diagnósticas que deben considerarse
- CT/MRI head
- EEG
- CSF viral culture
Pruebas emergentes
- CSF C-reactive protein (CRP)
- serum and CSF procalcitonin
- CSF lactate
Algoritmo de tratamiento
possible bacterial meningitis
confirmed viral agent, other than HSV, varicella zoster, or CMV
HSV or varicella zoster confirmed causative agent
CMV confirmed causative agent
recurrent viral meningitis
Colaboradores
Consejeros especializados
John Williams, MRCP, DTM&H
Consultant
The James Cook University Hospital
Middlesbrough
UK
Divulgaciones
JW declares that he has no competing interests.
Agradecimientos
Dr John Williams would like to gratefully acknowledge Dr David Chadwick, a previous contributor to this topic.
Divulgaciones
DC is an author of a reference cited in this topic.
Revisores por pares
Karen Roos, MD
John and Nancy Nelson Professor of Neurology
Indiana University School of Medicine
Indianapolis
IN
Divulgaciones
KR declares that she has no competing interests.
Vassiliki Syriopoulou, MD
Professor of Pediatrics
University of Athens
Aghia Sophia Children's Hospital
Athens
Greece
Divulgaciones
VS declares that she has no competing interests.
Referencias
Artículos principales
McGill F, Heyderman RS, Michael BD, et al. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. J Infect. 2016 Apr;72(4):405-38.Texto completo Resumen
Centers for Disease Control and Prevention. About viral meningitis. Jan 2024 [internet publication].Texto completo
Miller JM, Binnicker MJ, Campbell S, et al. Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. 2024 Mar 5 [Epub ahead of print].Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Meningitis, bacterial
- Encephalitis
- Encephalopathy (toxic/metabolic)
Más DiferencialesGuías de práctica clínica
- Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases
- The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults
Más Guías de práctica clínicaFolletos para el paciente
Meningitis and septicemia
Lumbar puncture
Más Folletos para el paciente
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